Aaron Mitchell
@thewonkologist.bsky.social
Medical oncologist and health services researcher. Focusing on health care costs, physician-industry COI, and oncology reimbursement reform. Opinions mine.
Huge kudos to @abduaziz.bsky.social for leading this study, and huge thanks to @dusetzinas.bsky.social as always for her ideas!
And another huge thank-you to our funders, @commonwealthfund.org @arnoldventures.bsky.social @johnarnoldfndtn.bsky.social
And another huge thank-you to our funders, @commonwealthfund.org @arnoldventures.bsky.social @johnarnoldfndtn.bsky.social
November 11, 2025 at 5:39 PM
Huge kudos to @abduaziz.bsky.social for leading this study, and huge thanks to @dusetzinas.bsky.social as always for her ideas!
And another huge thank-you to our funders, @commonwealthfund.org @arnoldventures.bsky.social @johnarnoldfndtn.bsky.social
And another huge thank-you to our funders, @commonwealthfund.org @arnoldventures.bsky.social @johnarnoldfndtn.bsky.social
Policy implications?
Price declines from biosimilars are great, but could be even better.
CMS should consider additional mechanisms to accelerate price competition. MedPAC has proposed such mechanisms:
5/
www.medpac.gov/wp-content/u...
Price declines from biosimilars are great, but could be even better.
CMS should consider additional mechanisms to accelerate price competition. MedPAC has proposed such mechanisms:
5/
www.medpac.gov/wp-content/u...
www.medpac.gov
November 11, 2025 at 5:39 PM
Policy implications?
Price declines from biosimilars are great, but could be even better.
CMS should consider additional mechanisms to accelerate price competition. MedPAC has proposed such mechanisms:
5/
www.medpac.gov/wp-content/u...
Price declines from biosimilars are great, but could be even better.
CMS should consider additional mechanisms to accelerate price competition. MedPAC has proposed such mechanisms:
5/
www.medpac.gov/wp-content/u...
In this study, we compared biosimilar prices not to the pre-launch price of their originator, but to the counterfactual of where that price likely would have been absent competition. Drug prices rise over time, after all.
We believe this more accurately captures true price changes.
4/
We believe this more accurately captures true price changes.
4/
November 11, 2025 at 5:39 PM
In this study, we compared biosimilar prices not to the pre-launch price of their originator, but to the counterfactual of where that price likely would have been absent competition. Drug prices rise over time, after all.
We believe this more accurately captures true price changes.
4/
We believe this more accurately captures true price changes.
4/
Our understanding is that the "single HCPCS" reimbursement model used by CMS for generic drugs achieves accelerated price competition. However, each biosimilar receives a unique HCPCS, so price competition plays out over a longer time frame.
3/
3/
November 11, 2025 at 5:39 PM
Our understanding is that the "single HCPCS" reimbursement model used by CMS for generic drugs achieves accelerated price competition. However, each biosimilar receives a unique HCPCS, so price competition plays out over a longer time frame.
3/
3/
The conventional wisdom, for a while, was that savings from biosimilars were quite modest.
However, we found that biosimilar prices were about 2/3rds below where biologic prices would have been otherwise. So, savings are substantial. The rub: it took 5yrs post-market to get there.
2/
However, we found that biosimilar prices were about 2/3rds below where biologic prices would have been otherwise. So, savings are substantial. The rub: it took 5yrs post-market to get there.
2/
November 11, 2025 at 5:39 PM
The conventional wisdom, for a while, was that savings from biosimilars were quite modest.
However, we found that biosimilar prices were about 2/3rds below where biologic prices would have been otherwise. So, savings are substantial. The rub: it took 5yrs post-market to get there.
2/
However, we found that biosimilar prices were about 2/3rds below where biologic prices would have been otherwise. So, savings are substantial. The rub: it took 5yrs post-market to get there.
2/
I'm hesitant to call it an apples to apples comparison, though. Prior study looked at only one cancer type. And included a time frame (prior to 2005 MMA) when profit margins on cancer drugs were far higher, so very different environment)
November 5, 2025 at 7:32 PM
I'm hesitant to call it an apples to apples comparison, though. Prior study looked at only one cancer type. And included a time frame (prior to 2005 MMA) when profit margins on cancer drugs were far higher, so very different environment)
I'm aware of only one prior study that had a similar question and design as this one. It supported the opposite conclusion - profit margin seemed to matter.
pubmed.ncbi.nlm.nih.gov/23124970/
pubmed.ncbi.nlm.nih.gov/23124970/
Physician response to financial incentives when choosing drugs to treat breast cancer - PubMed
This paper considers physician agency in choosing drugs to treat metastatic breast cancer, a clinical setting in which patients have few protections from physicians' rent seeking. Physicians have explicit financial incentives attached to each potential drug treatment, with profit margins ranging mor …
pubmed.ncbi.nlm.nih.gov
November 5, 2025 at 7:31 PM
I'm aware of only one prior study that had a similar question and design as this one. It supported the opposite conclusion - profit margin seemed to matter.
pubmed.ncbi.nlm.nih.gov/23124970/
pubmed.ncbi.nlm.nih.gov/23124970/